M Dieterich1, F Hartwig2, J Stubert2, S Klöcking3, G Kundt4, B Stengel5, T Reimer2, B Gerber2. 1. Department of Obstetrics and Gynecology, Breast Unit, University of Rostock, Suedring 81, 18059 Rostock, Germany. Electronic address: max.dieterich@uni-rostock.de. 2. Department of Obstetrics and Gynecology, Breast Unit, University of Rostock, Suedring 81, 18059 Rostock, Germany. 3. Cancer Registry Rostock, Department of Radiotherapy, University of Rostock, Suedring 75, 18059 Rostock, Germany. 4. Institute for Biostatistics and Informatics in Medicine, University of Rostock, Ernst-Heydemann-Str. 8, 18057 Rostock, Germany. 5. Institute for Pathology, Hospital Suedstadt, Suedring 81, 18059 Rostock, Germany.
Abstract
BACKGROUND: Ductal carcinoma in situ (DCIS) often accompanies invasive ductal carcinoma (IDC). The presence of co-existing DCIS is postulated to present as a less aggressive phenotype than IDC alone. PATIENTS AND METHODS: Patients diagnosed with hormone receptor-positive breast cancer receiving mastectomy were evaluated. Only patients without adjuvant radio- and chemotherapy were included to decrease treatment bias on local recurrence (LR). RESULTS: Of 2239 breast cancer patients, 198 fulfilled the inclusion criteria. The overall LR rate was 11.6%. Tumor stage (p = 0.002), nodal status (pN2 vs. pN0, p = 0.023) and pure IDC compared with IDC-DCIS (p = 0.029) were multivariate independent factors for increased LR risk. Patients with IDC-DCIS were significantly younger (p < 0.001), had smaller tumors (p = 0.001), less lymph node involvement (p = 0.012). The LR rate was significantly increased in patients with pure IDC (p = 0.012). The time to distant metastases was decreased in patients with pure IDC compared with that observed in patients with IDC-DCIS (log rank = 0.030). CONCLUSION: Invasive ductal carcinoma accompanied by DCIS is associated with lower LR. The prognostic value of co-existing DCIS in the adjuvant decision-making process may be considered a new independent prognostic marker. This finding needs further studies to evaluate its usefulness in premenopausal women.
BACKGROUND:Ductal carcinoma in situ (DCIS) often accompanies invasive ductal carcinoma (IDC). The presence of co-existing DCIS is postulated to present as a less aggressive phenotype than IDC alone. PATIENTS AND METHODS: Patients diagnosed with hormone receptor-positive breast cancer receiving mastectomy were evaluated. Only patients without adjuvant radio- and chemotherapy were included to decrease treatment bias on local recurrence (LR). RESULTS: Of 2239 breast cancerpatients, 198 fulfilled the inclusion criteria. The overall LR rate was 11.6%. Tumor stage (p = 0.002), nodal status (pN2 vs. pN0, p = 0.023) and pure IDC compared with IDC-DCIS (p = 0.029) were multivariate independent factors for increased LR risk. Patients with IDC-DCIS were significantly younger (p < 0.001), had smaller tumors (p = 0.001), less lymph node involvement (p = 0.012). The LR rate was significantly increased in patients with pure IDC (p = 0.012). The time to distant metastases was decreased in patients with pure IDC compared with that observed in patients with IDC-DCIS (log rank = 0.030). CONCLUSION:Invasive ductal carcinoma accompanied by DCIS is associated with lower LR. The prognostic value of co-existing DCIS in the adjuvant decision-making process may be considered a new independent prognostic marker. This finding needs further studies to evaluate its usefulness in premenopausal women.
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